Middle Aged Man Pondering About Health Insurance

Tis the (thinking about health insurance) Season

In addition to football and colder weather, millions of Americans should be thinking about health insurance in the fall. We’ve outlined helpful hints below by major category of coverage. MEDICARE Annual Open Enrollment is October 15th through December 7th. This is a time anyone on a Part D drug plan can consider changing to another plan. This is also a time one can change from original Medicare to an Advantage Plan or from an Advantage Plan back to original

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Paying your premiums on time

In my role as healthcare coverage evangelist, there remain too many topics that, to my great dismay, are still relevant. One of the most important is: PAY YOUR HEALTH INSURANCE PREMIUMS ON TIME The obvious beauty of having coverage through an employer is that the employer subsidizes the coverage. Another beautiful aspect of group coverage is that your contribution comes out of your paycheck. Finally, when an employer offers group coverage, they’ve worked to select the Plan and budget funds to pay

New Medicare Cards with New Identification Numbers on the Way

Everyone who is enrolled in Medicare will be receiving a new card with a new claim or identification number (that is NOT a Social Security number) sometime between April 1, 2018 and March 31, 2019. Those going on Medicare for the first time effective April 1, 2018, will be the first to receive the new type of card. Social Security manages the enrollment for Medicare A and B so the cards will be mailed from Social Security. Is This a Big

Medicare’s Annual General Enrollment – January 1 through March 31, 2011

Medicare’s annual General Enrollment Period (GEP) begins on January 1st   and ends on March 31st every year. Why is it important to know if you need to enroll in Medicare during the annual General Enrollment Period? Medicare enrollment rules are strict, unforgiving, and punitive.  If you have to enroll during the General Enrollment Period you may pay Part B premium penalties for life and most have a gap in coverage, typically to the following July 1st.  Since Part B premiums are calculated back to the year

Maura Carley’s Book “Health Insurance: Navigating Traps & Gaps” is available on Amazon

“Maura Carley has written an important book for anyone who has to navigate our nation’s fractured, fragmented, inadequate health insurance system.  Case studies, drawn from years of experience helping individuals and families, provide insight into how these defects can affect us.  No one will emerge from reading this book without a deepened understanding of how today’s insurance model leaves us vulnerable to tragic medical and economic consequences.” David M. Lawrence Chairman and CEO (retired) Kaiser Foundation Health Plan and Kaiser Foundation Hospitals, Inc. San

More At Stake with Medicare

We want everyone to know about a service we’ve been offering for several years and about which we’ve received extremely and uniformly positive feedback, our Medicare Essentials Consultation. We have historically provided this educational and basic advisory service to individuals and couples. Recently we’ve also been engaged by larger companies and have received inquiries from a wide array of professional firms who want this information for their staff and retirees. Why do so many people want to learn about Medicare? This consultation was worth

Affordable Care Act Debate Misses Core Problem

Affordable Care Act Debate Misses Core Problem, Maura Carley, President, Healthcare Navigation, LLC Politics aside, many of us are not as blessed financially as Mitt Romney to be able to forego Medicare. In my opinion, the Republican Presidential candidate is making a big mistake, one that many Americans can’t afford to make. Will the Affordable Care Act, now being debated by the Supreme Court make health insurance any more affordable? No, it will not. The primary purpose of the Affordable Care Act is

Chief Justice John Roberts and the Affordable Care Act

Chief Justice John Roberts’ decision salvaged the Affordable Care Act.  Ironically, many of those who are euphoric about his decision have neglected to read his comments which are so highly critical of the Act.  A few excerpts from his opinion follow.  Comments in parentheses are mine as is the decision to bold certain sentences. Justice Roberts: We do not consider whether the Act embodies sound policies.” The guaranteed-issue and community –rating reforms (everyone can get coverage and sick people aren’t charged more) do

Medicare Part D Drug Plan Open Enrollment October 15 – December 7, 2011 for January 1, 2012 

The federal reform legislation which passed in 2010 has many controversial elements.  The reform legislation, however, is what brings us a new Medicare Part D Open Enrollment schedule which is very sane and welcome.  In all but the first year of the program, 2006, the annual enrollment season has been crammed into a November 15th to December 31st timeframe.  That narrow window made it difficult for plans to effectively handle changes and issue new identification cards for January 1.  For the first

More on Shrinking Out-Of-Network Benefits – The Claims Filing Deadline Trap

In an earlier communication we addressed the value, although dwindling value, of the out-of-network benefit. Remember, if you don’t have out-of-network coverage, and seek care from a provider outside of your Plan’s network, you won’t be covered. As a result, out-of-network benefits are an important protection even though payment rates from insurers have been driven down. Another issue to remember when using out-of-network benefits is your Plan’s claims filing deadline. Unlike in-network claims which are filed by the provider directly to the